Has the Business Applicant ever declared bankruptcy? Yes No If yes, Date of occurrence: Has any Principal, Guarantor or Co-applicant ever declared bankruptcy? Yes No If yes, Date of occurrence: Is the Business Applicant liable as guarantor or endorser on an existing or outstanding loan? Yes No If yes, Date of occurrence: Is any Principal, Guarantor or Co-applicant liable as guarantor or endorser on an existing or outstanding loan? Yes No If yes, Date of occurrence: Is the Business Applicant or any Principal, Guarantor or Co-Applicant a party to any legal claim or lawsuit? Yes No If yes, Date of occurrence:
Is the Business already pledging any assets for a loan or lease? Yes No If yes, Date of occurrence:
Is the Business Applicant or any Principal, Guarantor or Co-applicant currently past due on any taxes? Yes No If yes, Date of occurrence: Are there any tax liens filed against the Business Applicant, or any Principal, Guarantor or Co-applicant? Yes No If yes, Date of occurrence: Does Business Applicant own or lease occupied building? Own Lease
If leased, name of lessor: Mailing address of lessor:
Years remaining on lease:
Monthly lease payments, if applcable: $
Business Loan Application, Page 1, Rev. 0 /
BUSINESS INFORMATION
Taxpayer ID Number Year Business Began Operation Years Of Current Ownership Years owners have been in Annual Sales
this line of business $
Business Type:
Sole Proprietorship General Partnership Sub-S Corporation Nonprofit Organization
Individual Limited Partnership C-Corporation Professional Association
Limited Liability Partnership Limited Liability Company Other
Business Legal Name (exact legal name) DBA (if applicable)
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LOAN REQUEST
What are loan proceeds going to be used for: Collateral Available*:
*Loans will be secured by all business assets unless specific assets, acceptable to the Credit Union, are pledged. Please describe fully any such specific assets that you wish to use as collateral. Please note which assets, if any are pledged as collateral for other loans. Please note location of collateral if different than your business location.
Amount Requested: $ Term Loan
Term: Months Years Business Line of Credit (CreditLine)
Purchase Price: $ Commercial - Real Estate
(please include a copy of purchase order for equipment/vehicle purchases) Construction - Real Estate
Additional Information:
This request is to:
Refinance existing debt Purchase new equipment Manage seasonal cash flow shortages Purchase existing business
Buy-out partner(s) Purchase Vehicle(s) Acquire Real Estate Refinance commercial real estate
Other (describe):
(If Yes , please explain on separate sheet)
) )
Zip
State Zip
RELATED BUSINESS ISSUES
Description of Business or Service
Primary Contact Name
BUSINESS PHYSICAL LOCATION
(cannot be a P.O. box): Street AddressBUSINESS MAILING ADDRESS
(if different from above): Street AddressBusiness Phone
(
City
Business Fax
(
State
$
$
$
Yes Yes Yes
Payment per per per per
$
$
$
Average Balance Would you like to move the account to ?
$
$
$ City
FINANCIAL INFORMATION
Account Type Current Balance
Business Debts
(List all business debts, including accounts and payables. Include any existing outstanding debt. Use a separate sheet if necessary.) Payable to: Type of Account (Revolving, Term, etc.) Balance Owing Pay off with proceeds?Y es Y es Y es Yes
Business Deposit Accounts
Financial Institution
BUSINESS LOAN APPLICATION
Each owner, shareholder, partner or member owning 20 percent or more interest in the business must sign a personal
guaranty. A minimum of 1 guarantor is required regardless of percent of ownership. Additional guarantees may be required.
$
$
$
$
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BUSINESS LOAN APPLICATION - Continued
08/&34)*1."/"(&.&/5*/'03."5*0/
The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against applicants on the basis of race, color, religion, national origin, sex, marital status, age (providing the applicant has the capacity to enter into a binding contract); because all or part of the applicants income is derived from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The Federal Agency that administers compliance with this law concerning this creditor is the National Credit Union Administration, Region V (Austin), 4807 Spicewood Springs Rd., Suite 5200, Austin, Texas 78759.
If your application for business credit is denied, you have the right to a written statement of the specific reasons for denial. To obtain the statement, please send your written request within 60 days
of the date of the Creditor’s decision to , Attention: Business Lending, . The Creditor will send you a written statement of
the reasons within 30 days of receiving your request for the statement.
Please provide a copy of the company’s financial statements or tax returns for the last three years and interim financial statements for the current year. Please also provide guarantors’ tax returns for the last three years and updated personal financial statements.
Each Business Applicant and each person or entity signing this application (”Signer”) certifies that all information provided by the Business Applicant and the Signer is true and complete and authorizes ( ) and its agents to: obtain credit and employment information about the Business Applicant and Signer; obtain credit reports and make any inquiries and its agents consider appropriate in connection with this application or review of this loan account from time to time; make ’s experience with this loan account and information about this application available to credit bureaus, other Signers or other persons who have or expect to have financial dealings with the Business Applicant and the Signer; share collection information with the Signer’s other creditors; and disclose account information as required by law. Each Signer acknowledges that additional information may be required in order to make a final credit decision. Business Applicant also acknowledges receipt of the Equal Credit Opportunity Notice disclosure provided with this application.
All signers must also be duly authorized to sign on behalf of applicant.
Submitted to: Date:
If you are applying for individual credit in your own name and are relying on your own income, or assets and not the income or assets of another person as the basis for repayment of the credit requested, or if this statement relates to your guaranty of the indebtedness of other person(s), firm(s), or corporation(s), complete only Sections 1, 3, and 4.
If you are applying for individual credit but are relying on income from alimony, child support, or separate maintenance or on the income or assets of another person as a basis for repayment of the credit requested, complete all Sections. Provide information in Section 2 about the person whose alimony, support, or maintenance payments or income or assets you are relying on. Alimony, child support, or separate maintenance income, need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Name Name
Address Address
City, St & Zip City, St & Zip
Social Security # Social Security #
Date of Birth Date of Birth
Position or Occupation Position or Occupation
Business Name Business Name
Business address Business address
City, St & Zip City, St & Zip
Length at present residence Length at present residence
Length of employment Length of employment
Residence Phone Business Phone Residence Phone Business Phone
Have (either of) you or any firm in which you were a major owner ever declared bankruptcy, or settled any debts for less than the amounts owed?
If yes, please provide details on a separate sheet. Yes No
Are (either of) you a defendant in any suit or legal action? Yes No
Are (either of) you presently subject to any unsatisfied judgments or tax liens? Yes No
When, if ever, have (either of) you been audited by IRS? Yes No
Are (either of) your assets held in a Trust? Yes No If so, what type? Living Revocable Non-Revocable Other
(Do not include assets of doubtful value)
(omit cents) (omit cents) (omit cents) (omit cents)
Cash, Checking & Savings,
CD’s – see Schedule A $ $ Notes payable to banks & others
– see Schedule H $ $
U.S. Gov’t & Marketable
Securities – see Schedule B $ $ Due to Brokers $ $
Non-marketable securities –
see Schedule B $ $ Amounts payable to others –
secured $ $
Securities held by broker in
margin accounts $ $ Amounts payable to others –
unsecured $ $
Restricted, control or margin
account stocks $ $ Accounts & bills due $ $
Real estate owned – see
Schedule D $ $ Unpaid income tax $ $
Accounts, loans, & notes
receivable $ $ Other unpaid taxes & interest $ $
Automobiles $ $ Real estate mortgages payable –
see Schedules D & H $ $
Cash surrender value-life
insurance – see Schedule E $ $
Vested interest in deferred compensation/profit-sharing plans – see Schedule F
$ $
Business ventures – see
Schedule G $ $
$ $
Other assets/personal property itemize – see
Schedule G if applicable $ $
$ $
$ $ $ $
Personal Financial Statement, Page 1, Rev. 0 /
Annual Income Individual Joint Annual Expenditure Individual Joint Contingent Liabilities
Estimated Amounts Individual Joint
Salary, bonuses &commissions $ $ Mortgage / rental
payments $ $ Do you have any: (if ‘Yes’,
describe on separate page) $ $
Dividends & interest $ $ Real-estate taxes &
assessments $ $
Contingent liabilities (as endorser, Co-maker or Guarantor?)
Yes No
$ $
Real estate income $ $ Taxes - federal, state &
local $ $ (On leases or contracts)
Yes No $ $
Insurance Payments $ $ Involvement in pending legal
actions? $ $
Yes No Other contract
payments (car payments, charge cards, etc.)
$ $ Contested income tax liens?
Yes No $ $
Alimony, child support,
maintenance $ $
Any estimated capital gains tax on the unrealized asset appreciation?
Yes No
$ $
Other income (alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for
repaying this obligation.) $ $
Other expenses $ $ Other special debt or
circumstances? $ $
Yes No
$ $ $ $ $ $
Name of Financial Institution Type of Account Owner Joint Y/N If Pledged, to Whom? Balance
Number of Shares or Face
Value of Bonds Description In Name of Are these Registered, Pledged, or
Held by Others? Market Value Exchanges Where Traded
Number of Shares Description In Name of Are these Registered, Pledged, or
Held by Others? Value Method of Valuation
Description/Location of Real
Estate Investment Joint Y/N Date of Original Investment/Amount
% Owned By You
Market Value of Your % of
Investment Present Balance Monthly Payment
Mortgage Maturity
Date Mortgaged Owed To
Name of Insurance
Company Owner of Policy Beneficiary and Relationship Face Amount Policy Loans Cash Surrender Value
%
Vested Company Name Account Number Manner of Payout (Annuity,
Lump Sum, etc.) Distribution
Date Beneficiary Amount
List Name and Address of Any Business Venture In Which You Are a
Principal Partner
Your Position/Title in
Business Line of Business Business Years in Total Assets Listed in Section
3
Your % of Ownership
Net Worth of Business
Present Net Value of
Your Investment
Owing to (Acct. No.) Joint Y/N Date of Original
Borrowing/Amount Present Balance Due Monthly Payment Date of Final
Payment Secured by